HCA Profits Soar as Patient Care Suffers
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Just read this article about the HCA corporation. I've never worked at an HCA hospital but have heard plenty of negative comments about them on AN. I'm also from the area in South FL discussed... Read More

That is ridiculous. Did you conclude that from your personal anecdotal experience, versus a systematic study of outcomes, etc.?

My father worked for a hospital that was taken over by Columbia/HCA, and his experience negates the good experiences here. It was clear that they way to profit for the hospital was to fire a huge number of people, regardless of patient safety. After a few years HCA declared "victory" and bailed out.

Can anyone think of any HCA hospital that compares to good non-profit hospitals, of which there are many? Are those who do the rankings simply ignorant of all the world-class HCA hospitals?

I worked for them. The nurses are famous for fudging their notes to fit an unrealistic patient load (7 on tele, plus the LPNs pushes and assessments). My preceptor told me to say "patient not available" if the meds were late and that a head to toe assessment was not needed if I had the pt yesterday!! "get in get out!" REALLY?? what about blood clots? Lung consolidation? HELLO? Meds never stocked, no supplies, running to ICU to get meds from their stash. I left because it was so bad at my facility. COW's falling apart, no working BP machines etc... They ran out of alcohol swabs. I was literally going to other units to find alcohol as a brand new RN. It was horrible. I'm paying them back for their nurse specialty program because I absolutely will not work like that.

I can' get past the violation of EMTALA and sending patient's out of the ED just because they can't pay! If a hospital is capable of treating the patient's illness- that hospital is supposed to treat the patient!

As for the major boo boos in triaging- I hope that old doctor in the wheelchair lives long enough to be a patient in that hospital. His rich sacrum is just as prone to decubs as any poor man's.

As for that current CEO - there ought to be a rule or a law, a CEO MUST seek medical care in the hospital they run unless that hospital is not medically equipped to treat- if the goat needs a stent, and the hospital is capable of performing PTCA then he receives his care there- not quietly go to another hospital.
Paddywaggon to jail, Please!! I'll make sure it's wheelchair accessable.

I was just in the hospital (HCA) last week for a cholecystectomy and ERCP. First room I had was a 4 patient room, second time it was a private room (weird the difference a floor makes I guess).

The problem I have is that they fired almost all of their CNA's and replaced them with volunteers (yes some of them are desperate new grads). They have a very small inhouse group of CNA's to either work the floor or be a sitter, any time they need extra they hire from a registry. I was not really affected by the CNA situation, but I would think that if I needed to be cleaned or turned I would be SOL. All nurses had the max 5:1 so they were basically making a big circle passing meds and controlling pain.

So my stay wasn't awful, but I also didn't need a whole lot. Those were just a couple of my observations and some of what the volunteers/nurses shared with me.

I was just in the hospital (HCA) last week for a cholecystectomy and ERCP. First room I had was a 4 patient room, second time it was a private room (weird the difference a floor makes I guess).

The problem I have is that they fired almost all of their CNA's and replaced them with volunteers (yes some of them are desperate new grads). They have a very small inhouse group of CNA's to either work the floor or be a sitter, any time they need extra they hire from a registry. I was not really affected by the CNA situation, but I would think that if I needed to be cleaned or turned I would be SOL. All nurses had the max 5:1 so they were basically making a big circle passing meds and controlling pain.

So my stay wasn't awful, but I also didn't need a whole lot. Those were just a couple of my observations and some of what the volunteers/nurses shared with me.

This comment really isn't about HCA, but when I read lrobinson's post "desperate new grads," I had to mention that I recently was put down and flamed (not on allnurses!) because I said to someone "there is currently not a shortage of nurses, many can't find a job." One person I was speaking to said, "how ill-informed you are! There is a well-documented shortage of nurses, blah, blah, blah." (Failure to see the big picture.) Now, about HCA, I would be surprised if a volunteer was allowed to do actual, hands-on patient care. Isn't that setting them up for a potential lawsuit? I'm not saying they can or they can't, I am simply wondering.

Now, about HCA, I would be surprised if a volunteer was allowed to do actual, hands-on patient care. Isn't that setting them up for a potential lawsuit? I'm not saying they can or they can't, I am simply wondering.

That's what you would think, yet there they are, helping with clean-ups. Maybe they are not "allowed" to do it, so if a potential lawsuit comes up they can claim it was the employee being reckless and operating out of their scope of practice. Don't get me wrong, the nurses generally buddy up with other nurses to do most of their work, but on such a crazy busy floor I think it would be hard to say no to an extra pair of hands.

I think I might look into it further to see what they can and can't do. I definitely was saddened that many a new grad take volunteer positions and CNA jobs after they graduate. I am not knocking the job of a CNA (I am one), but it just feels like you could be so easily taken advantage of.

I used to be a traveler. Worked at a few HCA facilities....there were issues that I did not like, for example, we had to ask permission to draw blood, or start an IV. Now, as an experienced ED nurse, I usually knew who needed an IV. I felt very frustrated when someone who was having a clear problem came in and I had to sit on my rear waiting for "permission"

THere are really some issues with HCA. Then again, there are really issues at each hospital...

This may not be a very popular thing to say, or there are those who may think this is way out there: but, one that needs to be explored with reference tp " the issue of new grads working for free or any other nurse for that matter" This phenonmenon would be considered a form of Human Trafficking aka Debt Bonding.

Look up the definition of Debt Bonding on Wikipedia go all the way to the bottom and look at the other links and you will find "Student Loans" listed. Corporate Healthcare is using the vulnerablities and desperation of nurses- new grads with student loan debt to intice them into taking positions for free- work for free and offering them the sacred acute care experience to gain their first job, or nurses who have been out of the acute care area for more than 2-3 years to entered into a free labor force position.

Look at the nursing wages in this country and what has happened to them- flat, no raises to keep up with the economy or gone down, look at the messages sent out there about nursing unionization which had significantly fought for and protected those wages, look at the staffing conditions and the unsafe practice enviornemnts in our hospitals- its not just one hospital but many and unsafe is more the norm than not. Look at the federal healthcare trend in the change of focus from acute care to primary care and what does all think that is doing to the profits of the acutecare healthcare corporations in this country- cutting down on their profits( more patients being treated in the community and less in the hospital) and acute care healthcare corporate leaders are not supporting this shift of focus to the primary care model. Why is there not an abandonment of the old business practices( on the part of the CEO and the MBA in the financial depts of the healthcare corporations) that are not working for these healthcare institutions now a days- cut the direct care givers positions to "save money due to the economy and high cost of healthcare" . Why is it that doctors and Public health prepared professionals can come up with inovative, and on target plans to give cost effective and more common sense approaches by utilizing data mining, case management a and disease managment( essentiall RN positions) to the war on chronic diseases while cutting healthcare costs to treat diabetes, morbidly obese, cardiac disease medically complex patients in under served and uninsured areas of this country- the very patients they accuse of bleeding the healthcare dollars out of these institutions?

Corporate Healthcare America is without ethics and scrupples. I most definately think this is corporate healthcare's take on the "round about way" around the human trafficking laws in the US. First we have importing of foriegn nurses to take less paying jobs and they don't speak up like an american born nurse would, thus are willing to take any line of crap the CEO and the hospital adminsitration can fling at them and out of fear of loosing that workers permit and being sent back "home" to a country will worse working conditons and poorer wages. Now they have squeezd and shut down the new grad entry level into the hopsital envirorments, forced out the older nurses and locked out thoses who would re enter afew years of absence. Hense the only way to gain access is through taking the offering of "free labor workforce" Are these free labor job positions counting as current RN experience or the reuirement: atleast 1-2 yrs acute care experience qualifiying them to gain a first position??? on their resumes???? Who knows???

This issue will not be fought in federal courts but will have to be fought against by the nursing profession. Why because the lawyers for these CEO's have found ways around these laws. and the nursing profession is not up to/equipped/prepared to take on this kind of an undertaking to stop it. Leaving the nursing workforce vulnerable to exploitation!!
JMHO